Four Stages of Institutional Development in an Adolescent Psychiatric Hospital

The authors present a theoretical framework of institutional development in which they hypothesize that a new institution has six tasks to perform. Each task is associated with a critical stage of development, or critical issue that must be resolved. In a study of a small, fairly new adolescent psychiatric hospital, they identified four critical incidents that reflect the first four tasks of staffing, organizing, planing, and controlling; the incidents, the associated issues, and their resolution are described. The authors believe that psychiatrists have important roles to play in the developmental stages and in preventing institutional pathology.